Provider Demographics
NPI:1184674293
Name:AVGERINOS, FOKION (DC)
Entity type:Individual
Prefix:DR
First Name:FOKION
Middle Name:
Last Name:AVGERINOS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25220 NORTHERN BLVD
Mailing Address - Street 2:STE 210
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362-1344
Mailing Address - Country:US
Mailing Address - Phone:718-357-0297
Mailing Address - Fax:718-423-9825
Practice Address - Street 1:19411 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-3032
Practice Address - Country:US
Practice Address - Phone:718-357-0297
Practice Address - Fax:718-423-9825
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007732111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04425Medicare UPIN